Morning Sickness During Pregnancy

“Morning sickness” is a phrase used to describe nausea and vomiting in pregnancy.

For some pregnant women, the symptoms are worst in the morning and improve over the course of the day, but they can come at any time and last all day long. The severity of symptoms can vary from one woman to another as well.

Morning sickness affects about 75% of pregnant women during the first trimester. Roughly 50% of all pregnant women suffer from both nausea and vomiting, 25% have nausea only, and 25% are symptom-free. The nausea usually starts around six weeks of pregnancy, but it can commence as early as four weeks. It often gets worse over the next month or so.

No one knows with certainty what causes nausea during pregnancy, but it’s likely some combination of the many biological changes taking place in a woman’s body. Some potential causes include:

1. A heightened sense of smell and sensitivity to odors. It’s fairly common for a recently-pregnant woman to feel overpowered by the smell of food, perfume, and other environmental odors. Some smells can instantly trigger the gag reflex. (Some scientists believe this may be a result of higher levels of estrogen, but results are not conclusive.)

2. Human chorionic gonadotropin (hCG): The levels of this hormone increase quickly during early pregnancy. It’s not clear how hCG contributes to nausea, but it’s a leading suspect because the timing is auspicious: Nausea tends to peak around the same time as levels of hCG. Furthermore, conditions in which women have higher levels of hCG, such as carrying multiple fetuses, are associated with higher rates of nausea and vomiting.

3. Estrogen: This hormone, which also increases rapidly during the first stages of pregnancy, is another possible contributor to morning sickness. It’s also conceivable that other hormones play a role as well.

How do you deal with nausea, or morning sickness, during pregnancy?

a. There’s only one over-the-counter medication that is safe: Although it’s not officially approved for nausea, Emetrol is the only non-prescription morning sickness medication that’s considered safe during pregnancy. Reflux drugs such as Pepcid or Zantac sometimes work for women where vomiting is caused by stomach distress.

b. A combination of doxylamine and vitamin B6 can also be effective in dealing with nausea and vomiting in pregnancy for many women. Please ask your doctor or midwife if this duo might work for you and, if so, what dose you should take. Remember: Never take any medications, herbal supplements, or vitamins, when pregnant without first talking to your healthcare practitioner.

c. A third possibility is Zofran, which was originally meant to control symptoms of nausea in chemotherapy patients. It may be effective for pregnant women, but it’s quite expensive and not covered by many insurers.